Medications for Heart Attack

The information provided here is meant to give you a general idea about each of the medication categories listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Emergency medical personnel may begin treating you with medications before you reach the hospital. At the hospital, additional drugs will be given and you will likely receive medications to take at home after you are discharged.

Nitrates help relieve chest pain by dilating the arteries, which allows more blood to flow to the heart muscle. Early in treatment, nitroglycerin may be administered as a tablet placed under the tongue or infused through a vein. Long-term, nitroglycerin may be given on a regular basis through a patch, paste, or orally to control chronic chest pain.

Possible side effects include:

Low blood pressure

Headache

Thrombolytic Agents

Common names include:

Tissue plasminogen activator (tPA)

Streptokinase

Reteplase

Tenecteplase

Lanoteplase

A drug to dissolve or break up blood clots in the coronary artery may be given via an IV. Early treatment, within three hours of the
heart attack, offers the best chance for good results. Your medical history, age, and condition may prevent treatment with clot-busting drugs.

Possible side effects include:

Stroke

Hemorrhage

Antiarrhythmic

During a heart attack, damage to the heart muscle can increase the risk of abnormal heart rhythms. Unstable heart rhythms can prevent the heart from effectively pumping blood, and if serious, lead to sudden death. Antiarrhythmic drugs help the heart beat more normally, usually by suppressing abnormal beats or by regularizing the heart rate.

There are a wide variety of drugs available to treat the various causes of abnormal rhythms. In emergencies, some of these drugs are given via an IV. Oral forms of medication are used to treat more chronic
arrhythmias
. The main issue with these drugs is that unless the underlying rhythm problem can be corrected, they must be taken indefinitely. One of the more unpredictable side effects of some of these medications is the risk of making the arrhythmia worse. Talk to your doctor about the specific side effects or warning signs to watch for based on the drug you are taking.

Sodium Channel Blockers

Sodium channel blockers are a type of antiarrhythmic drugs. Examples of these medications include:

Procainamide

Quinidine

Disopyramide

Lidocaine

Flecainide

Tocainide

Amiodarone

Mexiletine

Propafenone

Moricizine

Beta Blockers

Common names include:

Acebutolol

Atenolol

Betaxolol

Metoprolol

Nadolol

Pindolol

Propranolol

Timolol

Carvedilol

Nebivolol

Beta blockers are another type of antiarrhythmic drugs. Beta blockers decrease demands on the heart and lower blood pressure. They may limit the amount of heart damage and help to prevent future heart attacks.
They can also be used for their antiarrhythmic effects.

Possible side effects include:

Low blood pressure

Slow heart rate

Fatigue

Sexual dysfunction

Action Potential-Prolonging Agents

Action potential-prolonging agents are another type of antiarrhythmic drugs. Examples of these medications include:

Bretylium

Sotalol

Dofetilide

Calcium Channel Blockers

Common names include:

Amlodipine

Felodipine

Isradipine

Nicardipine

Nifedipine

Verapamil

Diltiazem

Another type of antiarrhythmic drugs, calcium channel blockers lower blood pressure and slow the heart rate. These may be given to patients who cannot take beta blockers. They can also be used for their antiarrhythmic effects.

Possible side effects include:

Low blood pressure

Lightheadedness

Constipation

ACE Inhibitors

Common names include:

Enalapril

Lisinopril

Quinapril

ACE inhibitors lower blood pressure and help lower mortality in people who sustain significant damage to the heart muscle.

Statins are drugs that help to lower blood cholesterol levels. They may be prescribed along with a low cholesterol diet if you have
high cholesterol
.
Atorvastatin may reduce the risk of repeat stroke or heart attack.

Possible side effects include:

Headache

Muscle pain

Liver damage (rare)

Over-the-Counter Medications

Aspirin

Aspirin
may be given by emergency medical personnel and continued after admission to the hospital. Aspirin helps prevent clotting and reclosing of the artery. Aspirin should generally be taken with food to decrease stomach upset.

Possible side effects include:

Stomach upset

Gastrointestinal bleeding and stroke

Special Considerations

If you are taking medications, follow these general guidelines:

Take your medication as directed. Do not change the amount or the schedule.

Do not stop taking them without talking to your doctor.

Do not share them.

Know what the results and side effects. Report them to your doctor.

Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.

Plan ahead for refills so you don’t run out.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

How is a heart attack treated? National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/treatment.html. Updated December 17, 2013. Accessed April 10, 2014.